Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mary Shenouda, MD

Individual provider Ophthalmology Physician · NPI 1104801976

Mary Shenouda, MD is an Ophthalmology in Lake City, Florida. Graduated from Loyola University of Chicago, Stritch School of Medicine in 2001, 25 years ago. Practices with Columbia Eye Associates PA, a 7-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Florida, Indiana and Ohio.

Years since qualifying
25
Trained at
Loyola University of Chicago, Stritch School of Medicine
Licensed in
FL, IN, OH
In the registry since
2005
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

1615 SW Main Blvd
Lake City, FL 32025-1108
Phone: (386) 755-2785
Fax: (386) 755-1128
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 1252 Ralston Ave Ste 400, Defiance, OH 43512-1480 — (419) 782-6588

Specialties & licences

Ophthalmology Physician (primary) Taxonomy 207W00000X · Licence ME165007 (FL)
Ophthalmology Physician Taxonomy 207W00000X · Licence 01060074A (IN)
Ophthalmology Physician Taxonomy 207W00000X · Licence 88852 (OH)

Record details

NPI number1104801976
Entity typeIndividual (Type 1)
GenderFemale
Credentials MD
Sole proprietorNo
NPI enumeratedDecember 14, 2005
Last updated in NPPESDecember 14, 2023
Certification dateDecember 14, 2023
Mailing addressPo Box 489, Lake City, FL 32056-0489

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyOPHTHALMOLOGY
Medical schoolLOYOLA UNIVERSITY OF CHICAGO, STRITCH SCHOOL OF MEDICINE
Graduated 2001 (25 years in practice)
Group practice Columbia Eye Associates Pa — 7 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Lake City